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Tuesday, July 27, 2010

Adventures in dentistry

Recently, we took Melly to her first dental appointment. I was told that three years old was the age they're supposed to go, so I made her an appointment. She was pretty excited because they hyped up dentist visits at her daycare.

I took her to a large local pediatric dental practice. They had a child-sized dental chair and let Melly pick out what flavor toothpaste she wanted to have her cleaning with (bubblegum was one of the options, of course). They taught her about the machine that sucks water out of her mouth and the little whirly machine that cleans the teeth. When they gave her a little pair of sunglasses so the light wouldn't hurt her eyes, I almost died of cuteness.

One thing I wasn't impressed with was that there was nowhere for parents to sit in the room. There were no chairs around, so I was just kind of hovering over her uncomfortably. I know you surgeons stand in place for hours, but I can't. I finally asked if I could borrow the dental chair that was empty next to me, and the hygienist told me quite snootily that I could, but I'd have to get up immediately if someone needed it. She acted like wanting to sit during this hour long visit was a totally ridiculous request.

The dentist finally came in. He was very young and handsome and I liked him right away. He counted Melly's teeth as I ogled him. I thought to myself, "This is the best dentist's visit EVER!"

Dr. Cutiepie straightened up and faced me. "She's got some decay on her two upper molars."

"What?" I said.

"We can just fill them in for her," he said. "We'll give her a little nitrous gas and she won't feel it at all."

"What?"

All of a sudden, I wanted to throttle Dr. Cutiepie. I despised him. How could my three year old child have cavities? Was that even possible? Dr. Cutiepie was... what? Twenty five years old? He didn't know what he was doing. They didn't even have chairs in this goddamn place. Obviously he was making this up to get money. I don't know what kind of monster would do something like that, but I haven't trusted dentists since two of them tried to high pressure me into getting my wisdom teeth out. (My family dentist assured me I didn't have to.)

The dentist visit ended with the hygienist snapping a Polaroid of Melly and Dr. Cutiepie, which I promptly burned the second I got home.

My parents both had friends who were dentists, so I spent the night trying to figure out what to do. They said if she had cavities, it was better to get them filled. I felt awful. Why did my preschooler have cavities? I thought about her diet and started to blame myself. Maybe I let Melly have too many treats. But we don't give her any candy or fruit juice. Maybe we hadn't enforced toothbrushing well enough (or at all). My husband and I decided to initiate a fascist toothbrushing regimen.

But still, how could a three year old have cavities? I'm in my early thirties and I've NEVER had a cavity. Not even one! And believe me when I say my parents were not big enforcers of toothbrushing.

I decided to get a second opinion. There was another pediatric dental practice a few blocks away that had come highly recommended. I actually meant to book an appointment with them in the first place, but I got confused on Google Maps because the other practice was only a few blocks away. Why the hell were there two large pediatric dental practices three blocks apart? Who designs this stuff??

The new dentist was older and much less cute, and I was happy. And guess what? It turned out that Melly didn't have two cavities after all.

She had three.

The dentist explained to me that her back four molars came in without any enamel on them. He said she might have been ill when they were growing in or maybe it was genetic. He assured me it absolutely wasn't from anything I did wrong. I later discovered from my father in law that my husband required sealant on some of his teeth when he was a kid. So her cavities needed to be filled and the back four teeth sealed.

I decided to go with the second practice because the dentist was older and could make the Donald Duck voice. Also, he said that we didn't need nitrous, which I thought was bullshit and our insurance wouldn't even cover. We got the cavities filled and Melly was a rock star. Afterwards, she said, "It hurt a little, but not a lot."

Glad you got through, and it ultimately worked out well. Can't judge a book or a tooth by it's cover, or in this case, the enamel or good looks! A second dental opinion will often prove useful, preferably at an academic center if at all possible. In our case (see http://www.mothersinmedicine.com/2009/07/what-is-that-i-see.html) it was the first time I ever actually "used" a connection to have a semi-emergent 2nd (and MUCH better) opinion/assessment with an academic pediatric dental colleague.

Just so you know, even if the reason why she had cavities wasn't from not having any enamel, it still probably wasn't your fault.

I had cavities EVERY time i went to the dentist. And not just one most times, it was three or four. I brushed my teeth like normal and wasn't allowed to eat sweets most of the time. It was nothing my parents did or didn't do that caused me such dumb luck.

Turns out that as a child my teeth were too close together. No matter what i did i always had a cavity because food would get stuck between the teeth and even flossing couldn't get it out completely. Since i've been an adult i haven't had one cavity yet!

So i just thought i would let you know that there are many reasons why a child could have a cavity. or two. or five. :)

My little brother got his first and only cavity when he was 2 (guess my parents took him in sooner). It happens, and there's a good chance that with getting a sealant like I've had that she'll never get one again. It happens.

Aw, gee, it's nobody's fault, these things just happen. Why do you think there are pediatric dentists? Most of the time it's genetic--my little brother had all 4 of his baby molars capped before he was 6 because the enamel just didn't develop. I will tell you though, in my childrens' ped dentist office parents were strongly discouraged from staying with the children, the thought being they'd do better without Mama in the room and that was probably right. My girls always did fine, loved the dentist, and at 27 and 29 don't seem to be scarred at all.

Fizzy -- CLEARLY it's all your fault, and these MiMs are just trying to make you feel better. We all know that you really just use a bottle full of coke as a pacifier for Melly. Duh. But this is a civilized forum and we're trying to be nice.

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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